Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Pain management and postoperative careManaging opiate usersGuidelines on the management of opiate users admitted to hospitalPrescribing for drug usersIn order to ensure safe prescribing for patients who are receivingmethadone or buprenorphine (Subutex) for opiate dependency it isessential that communication with the Community Drug Team (CDT),GP, or dispensing community pharmacy is established when patientsare admitted and discharged from hospital.Emergency admissionsDoctors must ensure that the patient is a registered methadone orbuprenorphine user and this must be confirmed with the CDT, GP orpatient’s community pharmacy before methadone or buprenorphine isprescribed. If it is not possible to confirm this medication must not beprescribed and the guidelines should be followed for themanagement of opiate withdrawal symptoms.Doctors must be satisfied that a full assessment of the patient,including drug history, has taken place and that the correct dose hasbeen established and verified before prescribing methadone orbuprenorphine. Doctors must also be aware of other substances ofabuse that the patient may report to be taking. This also needs to beconfirmed with the CDT, GP or community pharmacy. If this cannotbe confirmed treat symptomatically.If the patient requires analgesia for further advice contact the PainTeam on bleep 2492 or 2493 or ward pharmacist.Planned admissionsDoctors and nursing staff must be satisfied that the dose and time ofthe last dose of methadone or buprenorphine taken by the patienthas been confirmed by the CDT, prescribing GP or communitypharmacy prior to administration of subsequent medication to thepatient.Anaesthetists Handbook January 2010 119